• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.31-34
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• 2012

Tension pneumothorax during one-lung ventilation (OLV) is a rare but life-threatening complication. A 79-year-old male patient who was diagnosed with lung cancer underwent $Univent^{(R)}$ Tube (Fuji Systems Corporation, Tokyo) intubation for left upper lobectomy. Two hours after the initiation of OLV, the patient could not tolerate it. Thus, one-and two-lung ventilation were alternatively applied to continue the operation. After the operation, an emergent chest radiograph was taken, and pneumothorax was found at the right (dependent) lung field.

• Journal of Biomedical Engineering Research
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• v.11 no.2
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• pp.195-202
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• 1990

The hypothesis of asymmetric resistance to explain the phenomenon of lung hyperinflation (LHI) during hlgh frequency ventilation (HFV) was quantitatively studied. LHI was predicted by modeling the ism-volume pressure-flow (IVPF) data from 5 human subjects using the empirical Rohrer's equation. Non-steadiness during HFV was compensated by em- ploying recently proposed volume-frequency diagram. Tidal volume and ventilation frequency were 100 ml and 20 Hz, respectively. Airflow pattern was a symmetric sinusoid. The predic- tion results of mean pressure drop across the airways were averaged for those 5 subjects, and compared with zero by one-sided student's t-test. A marginally significant (P<0.1) increase in mean pressure drop was observed during HFV at low lung volumes (below FRC) , which could increase mean lung volume up to one liter When the lung volume was above FRC, no significant LHI (P >0.25) was resulted. LHI seemed to be inversely related to the lung volume. These results recommend to clinically apply HFV only at lung volumes above FRC.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.293-300
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• 2022

Lung transplantation is the only treatment option for patients with end-stage lung disease. Although more than 4,000 lung transplants are performed every year worldwide, the standardized protocols contain no guidelines for monitoring during lung transplantation. Specific anesthetic concerns are associated with lung transplantation, especially during critical periods, including anesthesia induction, the initiation of positive pressure ventilation, the establishment and maintenance of one-lung ventilation, pulmonary artery clamping, pulmonary artery unclamping, and reperfusion of the transplanted lung. Anesthetic management according to the special risks associated with a patient's existing lung disease and surgical stage is the most important factor. Successful anesthesia in lung transplantation can improve hemodynamic stability, oxygenation, ventilation, and outcomes. Therefore, anesthesiologists must have expertise in transesophageal echocardiography, extracorporeal life support, and cardiopulmonary anesthesia and understand the pathophysiology of end-stage lung disease and the drugs administered. In addition, communication among anesthesiologists, surgeons, and perfusionists during surgery is important to achieve optimal patient results.

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.279-285
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• 2005

One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.527-530
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• 2003

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.

• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.9-15
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• 2015

Purpose of this study is to determine the reasonable portal approach for thoracoscopic right middle lung lobectomy in small sized dogs under 10 kg. Ten healthy beagle dogs weighing $8.67{\pm}0.49kg$ were included. Under general anesthesia, one-lung ventilation (1LV) was achieved using endobronchial blocker with guidance of fiber-optic bronchoscope. Two portal approaches were used; 8-6-10 intercostal space (ICS) and 8-6-5 ICS approach. Thoracoscopic right middle lung lobectomy was performed using endoscopic linear self-cutting stapler and specimen retrieval bag. Each approach was evaluated by scoring 0; bad, 1; endurable, 2; good, 3; excellent in following five category, 1) visualization, 2) triangulation; instrumental sword fighting in the thoracic cavity, 3) approach to hilar pedicle; application of stapler, 4) any obstacles in applicating Lap Bag, and 5) the operator's convenience. Favorable working space was secured by 1LV and thoracoscopic right middle lung lobectomy was successfully completed in all dogs. There was no need to change the portal location and iatrogenic complication. Most of scores were good to excellent in both approaches. Consequently, both approaches are feasible methods for thoracoscopic right middle lung lobectomy with one lung ventilation using endoscopic linear self-cutting stapler in dogs weighing less than 10 kg.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1104-1113
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• 2020

Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.571-584
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• 2004

Magnetic Resonance Imaging (MRI) is one of the most advanced imaging techniques in clinical and research medicine. However, clinical application of MRI to the lung or thorax has been limited due to various drawbacks. Low signal intensity of the lung and cardiac and respiratory movements are the most serious problems with MRI in thorax. Nevertheless, MRI is superior to CT in some selected patients with thoracic diseases. The role of clinical MRI in thoracic disease has been widened with improvement of MR equipments and development of new pulse sequences. Otherwise, functional assessment of lung by MRI has been studied for the last decade. These include perfusion MRI with or without contrast enhancement and ventilation MRI with oxygen-enhancement or hyperpolarized noble gas, $^3He$ and $^{129}Xe$.

• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.165-170
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• 2018

Background: The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV). Methods: The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCV-VG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP ($5cmH_2O$; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure ($P_{peak}$), mean airway pressure ($P_{mean}$), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP ($5cmH_2O$), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more. Results: The $P_{peak}$ was significantly lower in group TV6 ($19.3{\pm}3.3cmH_2O$) than in group TV8 ($21.8{\pm}3.1cmH_2O$) and group TV6+PEEP ($20.1{\pm}3.4cmH_2O$). $PaO_2$ was significantly higher in group TV8 ($242.5{\pm}111.4mmHg$) than in group TV6 ($202.1{\pm}101.3mmHg$) (p=0.044). There was no significant difference in $PaO_2$ between group TV8 and group TV6+PEEP ($226.8{\pm}121.1mmHg$). However, three patients in group TV6 were dropped from the study because $PaO_2$ was lower than 80 mmHg after ventilation. Conclusion: It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with $5cmH_2O$ PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.

• Journal of the Korean Society for Railway
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• v.3 no.2
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• pp.62-67
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• 2000

Modern people stay at indoor places about 90% of a day. Radon-222 is a gas produced by the radioactive decay of the element radium. And, radon is one of the major indoor air pollutants. Radon moves into the underground space through various routes and is considered to cause lung cancer by hurting the lung tissues. In this study, we measured the subway radon level at 9 stations of 3 lines. According to test results, we can figure out the concentration of radon by lines, times, and measuring points. So, it was found that ventilation conditions are the most important factors in the subway air quality. Finally, we suggested effective and economic management methods of air pollution in the subway.